Zygomatic arch deformation: an anatomic and clinical study.
OBJECTIVE
Trauma to the zygomatic arch classically leads to 1 of 3 injury patterns: fracture with medial displacement, fracture with posterior telescoping, or explosive burst with lateral displacement. We identified an additional injury pattern whereby the arch undergoes significant bending in the axial plane without fracture.


METHODS
In the anatomical part of the study, computed tomography (CT) scans of patients with arch deformation without fracture were analyzed for location, degree, and type of arch bending. In the clinical part, patients were divided into "arch deformation without fracture" and "arch fracture" groups and their demographic characteristics compared. Three patients from each group, all treated with the Gillies' technique, underwent postoperative CT scanning to compare accuracy of zygoma repair.


RESULTS
Bending occurred most commonly in the middle and posterior thirds of the zygomatic arch, with average deformation of 11 degrees . Post-Gillies' repair, average residual arch deformation was 2 degrees . Patients with arch deformation without fracture were significantly younger than those with arch fracture (24 yrs vs 42 yrs, P < .05). Unlike patients with arch fractures, all those with arch bending treated with the Gillies' maneuver had near anatomic zygoma realignment.


CONCLUSIONS
Zygomatic arch deformation without fracture occurs in 19% of zygoma injuries in our group and is likely elastic in nature. We believe this injury pattern is important clinically as it may decrease the need for coronal exposure, facilitate anatomic repair, and provide stability without hardware fixation.
Czerwinski
Marcin
M
The Craniofacial Center, Dallas, TX, USA. marcin.czerwinski@mail.mcgill.ca
Ma
Stephanie
S
Williams
H Bruce
HB
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D004548:Elasticity; D005146:Facial Asymmetry / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015050:Zygoma / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D015051:Zygomatic Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*